On May 5, 2026, the Ramsey County Board held a workshop from 10:30 a.m. to approximately 12:00 p.m. (morning session) to discuss the increasing utilization of state-operated mental health services and the associated rising costs for the county. The workshop featured presentations from Ramsey County Social Services staff, the state's Direct Care and Treatment agency, and detailed case studies illustrating systemic challenges. The afternoon session was scheduled to focus on cost trends and trade-offs.
Matt Clark Health Monitor Unity providing. Karen Francisco Manager of Medical Services and Supports. Possibly hear me telling the value of planning managers on this. Monica Long Director of Community Burger Chance. No way controller health problems. Christy Pops can I think nothing? Excellent. Today's discussion is about understanding why state hospital use is increasing and what is driving rising costs for the county. There are broader system pressures across behavioral health, housing, and justice systems. We want to ground this conversation who is being served, why they're there, and what happens when systems don't align. This conversation will help frame future policy investment and advocacy decisions. This morning focuses on people, utilization and discharge challenges. And the afternoon will focus on costs, trends, and difficult trade-offs. And as these comments stay, you know, we're going to be talking about dollars and policies and stats and numbers. But because that is our job as a policy-making body, but also that there are people and individuals behind each and every one of these statistics that we evolve very dear, and there are staff who are working to make sure that their care and custody is the best it can be. So we honor that as we have this discussion. With that, I will hand it off to our presenters. Thank you, Chair, Commissioners, County Manager, guests. Before we deep dive into this, I wanna thank uh Director Thompson, um, Deputy Director Walker for their leadership, um, the external partners that are here with uh with us today, and all of the other social service um managers and employees that have been working diligently on this uh topic as well. So thank you all for doing that work. Um so today we want to take a closer look to how the state operated care impact Ramsey County, both in terms of our system capacity and the individuals we serve. Uh we're also seeking uh clear shift within the behavioral health system, greater complexity, higher equity, um, and more individuals needing intensive level of care. As clients need to grow more complex, we're operating within a system that is often under understructed, under uh constructed and fragmented. As a result, we're not always able to fully meet the needs of our residents that we serve. But this um at the same time, there are gaps across the continuum of care that will make it difficult to move people through the systems into a stable appropriate placement. And response will strengthen our partnership with community, state, and local providers to better navigate these challenges and address both trends and gaps we are seeking. This workshop today is intended for two parts. Um, there's a lot of information that we will go through. The first part of the workshop today is going to be designed for the people side of things to show what our clients and residents are going through the process, and in the afternoon, we'll be focusing more on the system, um, the challenges, the barriers, um, the financial burden the county has. Um, and and we'll go into those details. Um, I know there's a lot of uh detailed information that we'll go through, so we um hope that we can go through this um workshop uh with you all. I know it's a lot of information. We hope to address the questions you have, hopefully at the end of the workshop. And with that, I will um hand it off to uh director Thompson to kick us off. Good morning, Chair Jevon Singh, County Manager, excuse me, county board and uh county manager Becker. Um this is a really complex topic, and we really thought long and hard about how to present this because it's a lot of information. And so I want a level set with that at the beginning here, so we can settle in. So we we intentionally said, let's do a morning workshop and let's do an afternoon workshop that allows us to get the breath. That allows us to get the breath. We know there'll be a lot of questions, and um, you'll see there'll be some natural points for that. But we're here this morning to tell a story. And we are going to tell that story through the eyes of um two individuals whose identity has been protected. And um, and when Charles comes up, he's gonna talk to you about um Jordan and Derek. And I we're gonna walk you through this. And so there is a moment where we're gonna ask you to kind of sit back and really listen about how people experience the system. And so I wanted to start with that because this is a really large and um complex, complex system, not just the individuals who experience civil commitment, but those who come through our state operated services. Um, we have some goals for you today. They include we really want you to have a foundational information about state operated services and state operated services sometimes in the past has been called direct care and treatment, interchangeable based on what time you've been involved with understanding state operated services. But we want you to understand that landscape and of who utilizes those services and those complex situations, because not everyone, as was mentioned in the morning a little bit ago. There are so many people who experience mental health as we are in mental health awareness month, right?